More than one in ten GP referrals to long Covid clinics rejected

Article By: Emma Wilkinson

More than one in ten referrals from a GP to a long Covid clinic is rejected for being clinically inappropriate, figures have revealed.

In England, there were 55,687 referrals to an NHS post-Covid assessment centre between 5 July 2021 and 10 April 2022, of which 49,159 were accepted, a Department of Health and Social Care analysis reported.

It means 12% of referrals nationally have been rejected as ‘clinically inappropriate’.

This pattern has been consistent throughout with more up-to-date figures from June showing 13% of referrals – 581 of the 4,837 made that month – were rejected.

In an assessment of the impact of the Omicron variant on health and the NHS, the DHSC said there are now an estimated two million people who have self-reported long-Covid.

The prevalence has increased due to the high numbers of people infected since the emergence of Omicron, the analysis said, as there is some evidence vaccination reduces the risk of developing long Covid symptoms.

GPs said they were not surprised by the data and complained that the current process was too onerous.

Dr Irfan Malik, a GP in Nottingham, said he thought 88% was high as ‘very few of our referrals actually make it through’.

‘Our rejection rate seems a lot higher than 12%. They usually bounce back the referral saying refer to x,y or z speciality,’ he said.

‘I feel patients with symptoms of long Covid need better access to long Covid clinics.’

Professor Azeem Majeed, professor of primary care and public health at Imperial College London said the experience in his own practice was that it is a lengthy process for GPs to refer patients to long Covid clinics.

‘In South London, there is a form that needs to be completed. The pre-referral information on the form includes a long list of blood tests and other investigations, such as chest x-ray, along with a physical examination.

‘We are required to do all the tests even when we don’t think some will add much information, for example, chest x-rays in people with no respiratory symptoms. Referrals are often returned because an item of information is missing.’

He added that the process of referral needed to be simplified with a much shorter referral form.

‘Most investigations should be organised by the long Covid clinics. The current system is creating a lot of work for primary care teams and delaying referrals.

‘Finally, when patients are seen in the clinics, the treatment options are usually very limited, which leaves patients very frustrated,’ he said.

Data from the Office for National Statistics shows the prevalence of self-reported long Covid is greatest among people aged 35 to 69 years, females, people living in more deprived areas, those working in social care, teaching and education or healthcare, and those with another activity-limiting health condition or disability.

Last month, NHS England said it would be up to ICSs to decide how support general practice in dealing with the growing problem of long Covid.

NHS England’s long Covid action plan announced that GP workload related to long Covid will be reduced by the introduction of local one-stop-shops and mobile clinics, intended to prevent people having to go back to their GP practice for multiple different tests.

However the plan stressed that ‘primary care will continue to be a core element of the patient pathway, often being the patient’s point of entry into long Covid care.’


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